Congress faces growing healthcare crisis in Puerto Rico

Nov. 20, 2017

Puerto Rico’s Medicaid funding crisis is deepening, adding yet another issue for Congress to deal with in what is sure to be a hectic December.

Hurricane Maria caused serious damage to Puerto Rico’s healthcare system, and none of the federal disaster relief money to date has been earmarked for the Medicaid program.

A $44 billion supplemental payment request from the White House on Nov. 17 said the administration was “aware” that Puerto Rico needed Medicaid assistance, but it put the onus on Congress to act.

Efforts to provide the money through legislation have failed so far. Advocates and lawmakers are now eying the upcoming year-end spending bill as a solution, given that the bill may become a “Christmas tree” loaded up with policy provisions.

But there’s no guarantee that the Medicaid money will make it in, as lawmakers are grappling with several hot-button issues heading into December, including immigration, Trump’s proposed border wall, ObamaCare payments to insurers, and an extension of the Children’s Health Insurance Program.

Advocates are worried Puerto Rico could get left behind in the legislative frenzy to come.

Some lawmakers blasted the Trump administration’s disaster request on Nov. 17, saying $44 billion is not nearly enough.

In a joint statement, House Energy and Commerce Committee ranking members Frank Pallone Jr. (D-NJ) and Senate Finance Committee ranking member Ron Wyden (D-OR) called on the administration to “immediately provide additional funding and extend a one-hundred percent funding match for Medicaid in Puerto Rico and the U.S. Virgin Islands just as we did in the aftermath of Hurricane Katrina.”

The territory has grappled with funding shortfalls. Before the storm, the island had enough Medicaid money to last until April 2018.

Now, experts predict that unless Congress acts, federal funding will be exhausted in a matter of months. If that happens, Puerto Rico—already cash-strapped—will be responsible for covering all its Medicaid costs going forward.

The Puerto Rican government has asked Congress and the Trump administration for help staving off the crisis. In late October, Gov. Ricardo Rosello requested $1.6 billion a year over the next five years.

The House earlier this month passed legislation reauthorizing CHIP that would also give Puerto Rico $1 billion a year for the next two years, specifically aimed at shoring up the island’s Medicaid program.

Despite the progress in the House on CHIP, the Senate has not moved forward with its version of the legislation.

Sen. Marco Rubio (R-FL) has expressed general support in recent months for helping to mitigate Puerto Rico’s Medicaid woes, but has not endorsed any specific proposals.

The Senate Finance Committee passed a CHIP bill without Puerto Rico funding, and ever since, the upper chamber has been focused on ObamaCare repeal and tax reform.

Congressional aides and outside lobbyists acknowledge that CHIP will likely only pass as part of the spending bill.

The Hill has the full story

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